Catastrophic Nurse Case Manager
4 months ago
Location: Signal Hill, CA
Required Qualifications:
- Registered nurse
- BSN preferred
- CCM or equivalent certification
- Three years or more of related experience and/or training or an equivalent combination of education and experience
- Identify, assess, plan, coordinate, implement, monitor, and evaluate options and services for individuals requiring case management services
- Provide quality, cost-effective outcomes for the client through collaboration and communication with the client, the family, the physician, and other members of the healthcare team
- Process the case utilizing the client's outcome management model and tools
- Obtain written authorization for case management services as well as release of information
- Assess the client/family to identify their strengths and resources; problems; psychosocial, financial, and medical history; current status; diagnosis; prognosis; functional status; goals; current treatment plan; and needs
- Develop a plan of care with client's model through interdisciplinary collaboration, which identifies realistic short- and long-term goals
- Identify, secure, and coordinate the services and resources to implement the plan
- Monitor services being provided for continued appropriateness and report to client and insurance carrier
- Evaluate the client's progress, the plan, and the appropriateness of the services provided, with modifications as necessary
- Provide ongoing instruction to the client and family regarding the injury/disease process, treatment options, and present care
- Promote the client's/family's self-advocacy skills to achieve maximum self-sufficiency
- Have knowledge of the benefit package as well as all available funding sources and systems of care and coordinate with the payer for authorization of payment
- Provide in-depth reporting of outcomes encompassing clinical, functional, financial, and customer satisfaction areas
- Demonstrate effective, accurate, and timely verbal and written communication in all work situations
- Identify and disclose all situations that might result in exposure to legal liability and/or are indicative of poor quality care negatively affecting the client
- Frequently travel to patient appointments
- Perform other related duties as assigned in accordance with the necessary job function
- Tremendous Career Growth Opportunities
- Senior management and leadership are very well respected by the team
- Great work environment with a family-like work culture
- Medical, Dental and Vision + 401k + Tuition Assistance + Disability
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